Attendant care benefits recalculated and awarded retroactively; 24-hour supervisory care denied based on factual findings.
The insurer appealed and the claimant cross-appealed an Arbitrator's decision regarding attendant care benefits (ACBs) and a special award for unreasonably withheld income replacement benefits (IRBs) following a motor vehicle accident.
The Director's Delegate corrected mathematical and rate errors in the Arbitrator's ACB calculation, increasing the monthly amount to $1,615.32.
The Delegate upheld the Arbitrator's factual finding that the claimant did not require 24-hour supervisory care, preferring the insurer's occupational therapy evidence over the claimant's assessor, who was found to lack objectivity.
The Delegate also held that section 39(3) of the SABS does not bar retroactive ACB claims, as it governs the timing of payment rather than entitlement.
The insurer's appeal against the special award was dismissed, as evidence supported the finding that IRBs were unreasonably withheld.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJul 21, 2014
